排尿障害と睡眠障害―α遮断剤はBPHの睡眠障害を改善するか

Dysuria and sleep disorder: Does alpha blocking agent have ability to normalize sleep disorder?

　「排尿障害と睡眠障害の関連」ならびに「前立腺肥大症（BPH）に対するα1遮断薬が睡眠を改善させるか」を検討した。対象はBPH群68例と器質的疾患のない（非BPH群）273例である。排尿障害の程度は国際前立腺症状スコア（I-PSS），QOLスコア（QOL-I），BPHによる影響指数（BPH-II）で，睡眠の質と量はピッツバーグ睡眠質問票（PSQI）で評価した。非BPH群は初診時のみ，BPH群は初診時とα1遮断薬投与4週間後に評価した。非BPH群ではI-PSS，BPH-II，QOL-IのそれぞれとPSQIとの間に有意な相関が認められた（p＜0.01）。また，BPH群ではα1遮断薬投与後にI-PSS，BPH-II，QOL-Iが改善しただけではなく，睡眠状態を表すPSQIも6.5±0.7から5.0±0.5に正常化した（p＜0.01）。

　The primary objective of this investigation was to assess relationship between dysuria and sleep disorder. Whether or not alpha blocking agent（tamsulosin）for benign prostatic hyperplasia（BPH）can improve sleep quality was also investigated. Sixty-eight patients with BPH（range：52-85 years old, mean：68.9）and 273 patients without BPH（19-88, 60.8）were included in this study. Patients with neurogenic bladder, urinary tract infection and circadian rhythm sleep disorder were excluded. The International Prostate Symptom Score（I-PSS）, BPH impact index（BPH-II）, and quality-of-life index（QOL-I）and the Pittsburgh Sleep Quality Index（PSQI）were then administered to all patients. Tamsulosin was given to all patients with BPH and were reevaluated with these questionnaires at 4 weeks after the treatment. In patients without BPH, there was a positive correlation with quality of urination（I-PSS, BPH-II, QOL-I）and PSQI（p＜0.01）. In patients with BPH, tamusulosin not only improved quality of urination but also normalized PSQI from 6.5±0.7 to 5.0±0.5（p＜0.01）. This investigation showed a positive correlation between dysuria and sleep disorder and also alpha blocking agent has ability to normalize sleep disorder in BPH patients.

（Rinsho Hinyokika 61：997-1001, 2007）